Nomination Form

for the Election of Board Members

Introduction for Information

The Board currently has 8 members whose term of office runs from 2018-19 to 2020-2021.

Board members elected at the AGM in March 2019 will serve as Board members Elect until 30 June 2019 and then as Board members from 1st July 2019 for a 3 year term until 30 June 2022. Board members may serve two consecutive terms, if re-elected after the first term, but must stand down after 6 years for a 3 year period before being eligible to serve again.

There are currently 4 vacancies on the Board that may be filled at this AGM.

The current Board is composed of Rotarians from 2 Districts in Victoria, Australia, and from 2 Districts in the USA, in California and Louisiana.

The Board would be especially pleased to receive Nominations from members in countries where we have larger numbers of members, that is: The Philippines, Nigeria and India. Of course we welcome Nominations from any of our members.

Name of Nominator and Declaration *

Name of Nominator and Declaration

I,……………………………………………………(Full Name) of ……………………..(Rotary or Rotaract Club or Alumni affiliation), in District ….. Zone…..being a member in good financial standing and aged over 18 years old

First Name

Last Name

Email Address *

Nomination *

hereby NOMINATE :

Nominee

Nominee

Name of Nominee

First Name

Last Name

Rotary affiliation and Declaration

of ……………………..(Rotary or Rotaract Club or Alumni affiliation), in District…. Zone……..being a member in good financial standing and aged over 18 years old
to serve as a Board Member of the Rotarian Action Group for Family Safety Inc. A0101A8541 from 1st July 2019 until 30 June 2022.

Signature(s) *

Signed by: …………………………………(nominator) on ……………………….(date) AND BY
………………………………….(nominee) on ……………………….(date)
who hereby confirms his or her willingness to serve as a Board Member.

Instructions for Return of Form

Please print, sign and return this form by email to ragfamsafe@gmail.com with the word Nomination in the subject line by 2 February 2019, attaching a brief biographical sketch (no more than 200 words) of the Nominee to help members decide between candidates. A recent photograph would also be useful, for posting on our website if the nominee is elected to the Board.